王贯新 马睿

[摘要]目的：探究無托槽隐形矫治对成人中度牙周炎患者牙周指标及唇侧外观的影响。方法：选取2017年6月-2017年11月笔者医院收治的91例中度牙周炎继发错牙合畸形患者为研究对象，均采用无托槽隐形矫治进行正畸治疗，比较治疗前后上颌中切牙牙根长度、牙槽骨高度及密度、唇侧功能和美观评分。结果：治疗后牙根长度（12.07±2.11）mm，较治疗前（12.84±2.15）mm降低（P<0.05），治疗前后牙根变化差值为（0.77±2.11）mm，吸收率为6.0%;治疗后唇侧、舌侧、远中位点及平均牙槽骨高度较治疗前无显著性变化（P>0.05），近中位点牙槽骨高度较治疗前升高，差异具有统计学意义（P<0.05）;治疗后，腭侧牙槽嵴顶处（A1）、解剖根尖点冠方1mm处（A3）骨密度较治疗前均降低，差异具有统计学意义（P<0.05），根中部位于根颈部和根尖中点处（A2）治疗前后无明显变化（P>0.05）;治疗后，患者牙齿排列、后牙咬合、前牙覆盖评分较治疗前降低，差异具有统计学意义（P<0.05）。结论：无托槽隐形矫治能有效缓解中度牙周炎患者的牙根吸收、保留牙槽骨高度和骨密度，可获得较好的唇侧外观效果。

[关键词]隐形矫治器;慢性牙周炎;牙根长度;牙槽骨高度;唇侧外观

[中图分类号]R783.5    [文献标志码]A    [文章编号]1008-6455（2021）04-0129-04

Effect of Invisalign on Root Length， Alveolar Bone Height and Labial Appearance in Adults with Moderate Chronic Periodontitis

WANG Guan-xin1， MA Rui2

（1.Department of Stomatology， Beijing Sixth Hospital，Beijing 100000， China;2.Department of Orthodontics，Beijing Chongwen Stomatological Hospital，Beijing 100007，China）

Abstract： Objective To explore the effect of bracketless invisible appliance on periodontal index and labial appearance in adult patients with moderate periodontitis. Methods  A total of 91 patients with moderate periodontitis admitted to our hospital from June 2017 to November 2017were selected for orthodontic treatment with bracketless invisible appliance. The root length， of maxillary central incisor，alveolar bone height and density， labial function and aesthetic score of upper incisor were compared before and after treatment. Results  The root length （12.07±2.11）mm after treatment was lower than that before treatment （12.84±2.15）mm （P<0.05）. The difference in root changes before and after treatment was （0.77±2.11）mm， and the absorption rate was 6.0%. The lateral， lingual， distal and average alveolar bone heights were not significantly changed compared to before treatment （P>0.05）， and the alveolar bone height at the mesialpoint was higher than before treatment （P<0.05）. After the treatment， the bone density at the apical palatal alveolar ridge （A1） and the anatomical apex at 1mm （A3） were lower than before treatment （P<0.05）， and the middle of the root was located at the root neck，there was no significant change at the midpoint of the root and apex （A2） before and after treatment （P>0.05）.After treatment， the teeth alignment， posterior jaw and anterior teeth coverage scores were lower than before treatment （P<0.05）. Conclusion Bracketless invisible appliance can effectively alleviate root resorption in patients with moderate periodontitis， preserve alveolar bone height and bone density， and obtain better labial appearance.

Key words：invisible appliance; chronic periodontitis; tooth root length; alveolar bone height;labial appearance

牙周炎是累及牙周膜、牙槽骨等深层牙周组织的慢性感染性疾病，患者常因牙周支持组织的丧失，引发咬合力失衡，从而继发牙唇向前移位、牙间隙、深覆牙合等畸形，对牙齿功能和美观造成较大影响[1]。而牙周炎继发的错牙合畸形又会引发牙齿松动、牙列不齐，造成菌斑堆积和牙周炎进一步发展[2]。经过完善牙周治疗后，正畸治疗能够排齐牙列、改善牙周炎，促进牙齿功能和美观恢复，是治疗牙周炎继发错牙合畸形的有效手段。传统固定矫治器存在托槽、弓丝，影响日常口腔维护，同时还能引发菌斑聚集、牙龈肿胀及出血等症[3]。无托槽隐形矫治器具有美观舒适、佩戴方便及易于清洁的优点而大量应用于临床，目前相关研究主要集中于对牙周组织健康的错牙合畸形患者疗效观察，对牙周炎错牙合畸形患者研究相对较少，且疗效指标多关注牙周软组织健康，对牙周硬组织、牙根长度评价较少[4-5]。……